Toria A. Powell
Cary
Summary
I am a healthcare professional with extensive experience in insurance verification and pre-authorization management at Mercalis. Expertise in resolving complex billing inquiries while ensuring HIPAA compliance. Proficient in Excel for data management and enhancing patient support services. Advocate with a strong background in legal proceedings, case management, and client consultation, resulting in improved client satisfaction and successful case outcomes. Passionate professional with a commitment to supporting clients in all aspects of cases. Excellent communication and relationship-building skills with diverse audiences. Friendly and engaging with strong team collaboration abilities.
Overview
10
10
years of professional experience
Work History
Patient Support Advocate
Mercalis
Morrisville
01.2023 - Current
- Confirmed patient insurance coverage, benefits, and eligibility for services utilizing various insurance systems.
- Coordinated with insurance companies to facilitate pre-authorizations for procedures and medications.
- Protected confidentiality of patient information according to HIPAA standards.
- Refined skill set through regular educational updates and advanced training.
- Facilitated application procedures for patient enrollment in assistance programs at bedside and monitored until finalization
Patient Support Advocate
Cigna
01.2019 - 01.2023
- Processed incoming claims efficiently to ensure timely resolutions.
- Executed pre-authorization requests to accelerate claim approvals.
- Researched billing inquiries and issues to provide accurate information.
- Managed high call volume while maintaining customer satisfaction.
- Typed 60 words per minute to enhance documentation speed.
- Utilized Excel, PowerPoint, Salesforce, and Microsoft Office for various tasks.
- Demonstrated reliability and quick learning capabilities in dynamic environments.
Prescription Services Coordinator
Imagine360
01.2015 - 01.2019
- Coordinated delivery of services to clients, ensuring timely and efficient support.
- Resolved helpdesk tickets through rx service queue for swift issue resolution.
- Managed emergency service requests by communicating schedules and expediting shipments.
- Provided customer service to enhance client satisfaction.
- Updated stakeholders on status of ongoing pharmacy setups to maintain transparency.
Education
High School Diploma -
Westchester Community College
Valhalla, NY05.2019
Graduate Certificate - Medical Assisting
Mandl School of Allied Health
New York, NY09.2004
Skills
- Insurance verification and claims processing
- Billing inquiry resolution
- Customer service and support
- Salesforce proficiency
- Time management
- Conflict resolution
- Microsoft Excel expertise
- Data entry accuracy
- HIPAA compliance
- Pre-authorization oversight
- Billing resolution
Languages
English, Professional
Timeline
Patient Support Advocate
Mercalis
01.2023 - Current
Patient Support Advocate
Cigna
01.2019 - 01.2023
Prescription Services Coordinator
Imagine360
01.2015 - 01.2019
High School Diploma -
Westchester Community College
Graduate Certificate - Medical Assisting
Mandl School of Allied Health
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